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Monday, January 28, 2013

Back to the Farber

Today was my monthly visit to DFCI for blood tests and Zometa infusion.  As usual, this was preceded yesterday by the annoying ritual of collecting a 24-hour urine sample.  It didn't go so well.  First of all, I forgot to use the collection bottle mid morning.  Oops.  Then we went out to see an early showing of Le Miz (excellent movie!), after which we met friends for a late lunch.  I had forgotten to bring my collection bottle along, so I wasn't sure how I was going to last through all of this.  I carefully monitored my liquid intake to make it easier.  Fortunately, I was able to hold off without much discomfort until we got home.  So then what did I do?  I immediately rushed to the bathroom and peed in the toilet!  I heard Gretchen scream "No!", but it was too late.  Duh!

I almost gave up on whole thing at that point, but I decided to continue anyway.  I didn't want to have to repeat this process and make a special trip into Boston to submit my sample.  This morning, I dutifully handed the nurse the bottle containing what pitifully small amount of urine I had collected.  I noted my mental lapses on the form I handed in with the sample.  I have no idea what effect all this will have on the results, if any.  Oh well.

The hematology results came back pretty quickly.  The good news is that my platelets are in the normal range and my RBC, HCT, and Hgb counts have improved, so I'm less anemic than I have been.  However, my White Blood Cell (WBC) count dropped from 3.1 last month to 2.6 (normal is above 3.8).  This was of concern to Mary and Muriel (not to mention me), because it could mean that my neutrophil count might have dropped as well, which is the most important number that they track on a monthly basis.  The differential test showing the absolute neutrophil count (ANC) is always the last result to come in, usually 45 minutes to an hour later than the other results.  If the ANC falls below 1.0, I have stop taking the Revlimid and perhaps start taking Neupogen shots to build them back up, not a pleasant prospect.

The other concern is that I was scheduled today to receive the first set of my "baby" immunization shots.  When my bone marrow was destroyed for my stem cell transplant, my body's immune system "forgot" all the previous immunities that I had built up during my lifetime.  My new immune system was reset to zero and is therefore like that of a baby.  I need to redo all the standard immunizations that children get.  If my neutrophil count today was too low, I would have to postpone these shots.

So we sat in the waiting room as I constantly monitored the online Patient Gateway looking for the all-important ANC result to pop up.  Finally it did.  To our relief, the number was 1.28, down from 1.49 last month, but still well above the threshold.  Whew!

So in addition to the Zometa, I got 4 vaccination shots today (my arm is still sore).  Most of these will be familiar to anyone with a young child:  DTaP, Haemophilus (Hib), Pneumococcal (Prevnar), and finally, inactivated polio (IPV).

The last one is the most poignant.  During my childhood in the early 50s, polio was a dreaded disease.  I remember seeing the ambulance taking away Mr. Pershing across the street, who never returned.  The Jennings boy across town was confined to an iron lung for years before succumbing.  Stories like this abounded.  In our family, my little 2-year-old brother, Terry, was the victim, which affected his left arm.  He spent almost a whole year confined to a rehab facility in Pittsburgh.  We could only visit once a week.  Those were traumatic, wrenching times.  A year later, Dr. Jonas Salk invented his savior vaccine, and the pandemic eased.

It was too late for Terry, however, whose arm was permanently crippled.  To his immense credit, this has never been an impediment for him.  If anything, it has made him more resolute in overcoming obstacles in his life.  He has always dealt with his situation with grace and humor.  Terry would later take up the game of golf, and it both pains me and gives me pride to report that he is a better golfer than I.  Over the years, when asked by other golfers what his handicap is, his stock answer with a straight face has been, "polio". 

Yes, I'm proud of my "little" brother (who happens to be half a foot taller than I am).  Here's to you, Terry!

1 comment:

  1. The 24 hour urine collection is annoying. I'll bring it to work on occassion in a cooler and I get so many comments and questions. Offering to show it to people usually ends the comments very quickly.